Lewy body dementia Causes

The exact origin of Lewy Body Dementia (LBD) remains unclear; however, researchers are gaining insights into its biological and genetic underpinnings. It has been established that the buildup of Lewy bodies correlates with the degeneration of specific neurons in the brain responsible for producing two crucial neurotransmitters that facilitate communication between brain cells. One of these neurotransmitters, acetylcholine, is vital for memory and learning processes. The other, dopamine, significantly influences behaviour, cognition, movement, motivation, sleep, and emotional states.

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Lewy Body Dementia Risk Factors

Scientists are studying risk factors for LBD, including age, Parkinson’s disease, REM sleep behaviour disorder, family history, and genetic variations in APOE, SNCA, and GABA genes. Age is the greatest risk factor, but no lifestyle factor has been proven to increase LBD risk.

Lewy body dementia signs and symptoms

People with LBD may not have every symptom associated with the disease. Any sudden or major change in functional ability or behaviour should be reported to a doctor.

The most common symptoms include changes in cognition, movement, sleep, and behaviour.

Cognitive symptoms of Lewy body dementia

LBD causes changes in thinking abilities. These changes may include:

• Visual hallucinations, often early on, occur in up to 80% of people with LBD, while nonvisual hallucinations, like hearing or smell, are less common but may also occur.
• Unpredictable changes in concentration, attention, alertness, and wakefulness from day to day and sometimes throughout the day. Ideas may be disorganized, unclear, or illogical. These kinds of changes are common in LBD and may help distinguish it from Alzheimer’s disease.
• Severe loss of thinking abilities that interfere with daily activities. Unlike in Alzheimer’s dementia, memory problems may not be evident at first but often arise as LBD progresses. Other changes related to thinking may include poor judgment, confusion about time and place, and difficulty with language and numbers.

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Movement problems and Lewy body dementia

LBD patients may experience mild movement symptoms, such as handwriting changes, early on, and may not experience significant movement problems for several years.

• Muscle rigidity or stiffness
• Shuffling walk, slow movement, or frozen stance
• Tremor or shaking, most commonly at rest
• Balance problems and repeated falls
• Stooped posture
• Loss of coordination
• Smaller handwriting than was usual for the person
• Reduced facial expression
• Difficulty swallowing
• A weak voice

LBD and sleep

Sleep disorders are common in people with LBD, but are often undiagnosed. A sleep specialist can help diagnose and treat sleep disorders. Sleep-related disorders seen in people with LBD may include:

• REM sleep behaviour disorder
• Excessive daytime sleepiness (sleeping two or more hours during the day)
• Insomnia
• Restless leg syndrome

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Behavioural and mood symptoms of LBD

Changes in behaviour and mood are possible in LBD and may worsen as the person’s thinking abilities decline. These changes may include:

• Depression
• Apathy, or a lack of interest in normal daily activities or events and less social interaction
• Anxiety and related behaviours, such as asking the same questions over and over or being angry or fearful when a loved one is not present
• Agitation, or restlessness, and related behaviours, such as pacing, hand wringing, an inability to get settled, constant repeating of words or phrases, or irritability
• Delusions, or strongly held false beliefs or opinions not based on evidence. For example, a person may think his or her spouse is having an affair or that relatives long dead are still living.
• Paranoia, or an extreme, irrational distrust of others, such as suspicion that people are taking or hiding things

Other symptoms of LBD

People with LBD can also experience significant changes in the part of the nervous system that regulates automatic functions such as those of the heart, glands, and muscles. The person may have:

• Changes in body temperature
• Problems with blood pressure
• Dizziness
• Fainting
• Frequent falls
• Sensitivity to heat and cold
• Sexual dysfunction
• Urinary incontinence
• Constipation
• A poor sense of smell